Trauma exposure, DSM-5 posttraumatic stress disorder, and binge eating: Results from a nationally representative sample

Abstract

Important links between trauma exposure, post-traumatic stress disorder (PTSD), and engagement in health risk behaviors have been demonstrated. However, most previous studies have utilized self-report measures rather than diagnostic interviews in assessing post-traumatic stress symptoms, have assessed PTSD using DSM-IV rather than contemporary DSM-5 diagnostic criteria, and have focused their investigations on select maladaptive health behaviors (e.g., substance use, smoking) and/or populations (e.g., clinical samples, women). Importantly, possible gender differences in the occurrence of these associations have been neglected. The current study will execute three aims in a nationally representative sample of the US general population: 1) Examine the impact of trauma exposure, PTSD, and subthreshold PTSD on a number of health risk behaviors (i.e., overeating, risky sexual behavior, smoking, and lack of physical activity), irrespective of the presence of comorbid mental disorders. 2) Investigate whether these associations differ in men and women. 3) Clarify whether the specific nature of the trauma (e.g., child abuse, motor vehicle accident, natural disaster) and PTSD symptom clusters display differential links with health risk behaviors. Participants and Methodology: Data will come from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III: 2012-2013), a nationally representative sample of 36,309 non-institutionalized adults residing in the US. PTSD and other mental disorders were assessed with a computer-assisted, structured diagnostic interview. All interviews were conducted face-to-face. Implications: The results of this study could guide the development of population-based approaches for targeting health behavior change within trauma-exposed populations, and inform gender-specific pathways between posttraumatic symptoms and specific physical health conditions.